Congenital heart disease symptoms in children. Everything parents need to know about congenital heart disease in their child

Heart disease in children is a pathology in which deformed valves, septa, holes between the heart chambers and blood vessels, provoke a violation of blood circulation through the internal heart vessels.

The main reasons for the development of heart disease in a child:

hereditary predisposition;
pregnancy proceeded under the influence of negative external factors: poor ecological environment, smoking or mother's use of alcoholic beverages or certain drugs;
"chromosomal anomaly", when one of the genes has undergone a mutation;
pregnancy was accompanied by the presence of infectious diseases (for example, rubella);
the fact of a miscarriage or stillbirth that happened earlier.

Classification

The classification of cardiac pathologies is carried out taking into account many parameters, since the heart is a difficult organ to study. Allocate the main types of heart disease: congenital (CHD) and acquired (PPS).

Congenital

The classification of pathologies of a congenital nature divides them into types, depending on the impact on the development of the child. Unfortunately, in recent years, the frequency of CHD in infants and premature babies has been increasing, and the anatomical features of the disease have been modified.

According to the simplest and most informative division, the UPU Children have 3 types:

white;
blue;
CHD, in which the outflow of blood is blocked by blockages.

white type

CHD of the white type is manifested by pallor of the skin. It is characterized by the ejection of blood from the arterial circulation into the venous circulation. White UPU is an open ductus arteriosus and is determined by the presence of isolated damage to the aorta, septum.

The defects of the white type include defects of the interventricular and interatrial septum, etc.

blue type

Blue type defects (blue CHD) visually distinguished by cyanosis of the skin (persistent cyanosis). The classification of blue CHD distinguishes such pathologies:

transposition of the great vessels (a process in which the aorta departs from the right ventricle, and the pulmonary artery, on the contrary, from the left);
triad of Fallot (a combination of several disorders: narrowing of the pulmonary artery, ventricular septal defect, aortic and right ventricular disease);
atresia of the right venous orifice, pulmonary artery, aorta.

CHD with outflow blockages

A congenital defect with blockages is a type of pathology, obstruction of the correct ejection of blood from the ventricles. The group of diseases includes:

stenosis - often such a disease is manifested by a narrowing of the aorta in the valve area;
coarctation of the aorta - a pathology accompanied by narrowing or complete closure of the lumen in a limited area;
Pulmonary stenosis is a disorder in which the outflow tract of the right ventricle narrows, causing barriers to the outflow of blood from it into the pulmonary artery.

Acquired

The main reasons for the development of PPS in children:

rheumatic endocarditis;
diffuse connective tissue disease;
infectious with valve damage;
in some cases, chest trauma.

Acquired malformations in children and adolescents are characterized by constant changes in the structure of the cardiac regions. The first changes are carried out after the birth of a child, causing dysfunction of the functioning of the heart. In medical practice, acquired heart defects are classified differently.

Origin:

rheumatic;
syphilitic;
atherosclerotic;
traumatic, etc.

According to the severity of the defect:

defects without significant impact on intracardiac hemodynamics;
defects with moderate or severe severity.

According to the state of general hemodynamics, the defect is:

compensated;
subcompensated;
decompensated.

There are also classifications according to the localization of heart disease and functional form.

Symptoms

Symptoms of the disease are not always detected at the initial stage of the development of pathology. Very often, the signs of the disease in a child appear after a few months or years. In newborn babies, the symptoms of a heart disorder differ depending on the presence of a specific anomaly, but their signs can be summarized:

inadequate supply of nutrients and oxygen to the child's body.

Babies between 1 and 2 years of age may experience bouts of anxiety and agitation. Children over the age of 3 show the following symptoms:

enlarged liver;
weak appetite or its absence;
shortness of breath;
children often get colds;
disturbed heart rhythm;
difficulty in performing physical exercises.

Congenital pathology of the heart, depending on its type (white or blue), is characterized by the color of the skin.

The clinical symptoms of PPS are often determined only with the help of diagnostics, taking into account the type of defect, its severity and development. Signs appear depending on the parameters of localization and the number of affected valves. Also, the symptoms of an acquired defect in a child may differ depending on the functional form of the pathology.

The main symptoms that help recognize PPS:

headache;
dizziness;
shortness of breath and pain physical activity;
feeling of heaviness and pain in the right hypochondrium;
pale skin and swelling of the legs;
cases .

Diagnostics

Diagnosis of the disease in a child is a mandatory study at the stage of intrauterine development. At the 14th week of pregnancy, the attending physician prescribes an ultrasound of the heart (echocardiography) for each woman.

Ultrasound is the main method for detecting CHD and PPS. Diagnosis using ultrasound helps to visualize the structural divisions of the heart, as well as calculate pressure and additional parameters.

If a heart disease is suspected, the cardiologist will prescribe additional diagnostic methods to help identify concomitant pathologies:

Electrocardiography (ECG)– Diagnosis of congenital and acquired defects at any age. It also fixes arrhythmia, displacement of the electrical axis, disorders of the conduction system. An ECG is included in the list of mandatory examinations for babies of one month of age.
X-ray examination displays the chest on the screen and is used to determine the current state of the heart.

Treatment

Specialists choose a method of treatment, taking into account the type of pathology, stage of development and complexity in each case. important role in choosing the best option therapy plays the condition and age of the sick child. There is no single answer on how to treat heart disease.

The most common treatment is surgery, but sometimes conservative therapies are sufficient.

conservative

Conservative therapy often includes diet, general hygiene, and exercise. Sick children are advised to eat protein-rich foods, limit water and salt, and avoid eating before bed. You need to do special exercises (for example, walking) that help train the heart muscle.

Surgical

The operation in 72% of cases of diseases becomes a chance for a complete recovery of the baby. Its success depends on timeliness. Thanks to the development of modern surgery, there is the possibility of early correction of CHD even in small and premature babies.

Surgery to remove a heart defect will be of two types:

open surgery, in which the cavity of the heart is opened;
a closed operation, when the operation is performed on large blood vessels near the heart, while the surgeon does not affect the organ itself.

During the operation, the heart and lungs are disconnected from the circulation of blood, during which it is enriched with oxygen, which spreads throughout the body. If the case is complex, additional surgical intervention is required with a break from the previous one in the time interval from several months to 1 year.

Many parents are concerned about the cost of saving their child's life. The cost of surgery depends on the nature of the pathology and the class of the chosen clinic. For example, in domestic clinics, the price for a radical replacement of Fallot's tetrad will be from 110,000 to 130,000 rubles. In foreign clinics, the price of heart surgery varies from 12,000 to 22,000 euros.

The appearance of a baby in the family is always happiness. But the joy of parents fades sharply when they hear such a diagnosis as heart disease. Unfortunately, in recent times heart defects in children are quite common. This disease is associated with impaired development of the heart and large vessels in babies, which leads to changes in blood flow, overload and myocardial insufficiency. Heart disease in children is congenital. According to statistics, from 5 to 8 children out of a thousand have this cardiovascular disease. All types of congenital pathologies are diverse in their anatomical features and severity of the course. Many of them are found in various combinations. With forms incompatible with life, children do not live up to a year. After the first year of life, mortality decreases, and in the period from 1 to 15 years, about 5% of sick children die from heart defects. As you can see, the disease is very serious, requiring a special approach and comprehensive treatment.

Heart disease symptoms

Some types of birth defects are diagnosed and successfully treated in the early stages, and some are asymptomatic for months or even years. After three years, the following deviations can be noticed in sick children:

poor appetite
liver enlargement
rapid breathing
frequent colds
cardiac arrhythmia
difficulty with physical activity

Older children may also complain of pain in the chest or under the shoulder blade, dizziness and headaches. Symptoms of heart disease in newborns may differ depending on specific anomalies, but common to all are heart failure, as well as insufficient supply of nutrients and oxygen to tissues and organs.

According to the features of the discharge of blood, congenital heart defects are blue and white. As a rule, a decrease in the concentration of oxygen in the arterial blood manifests itself with the birth of a baby. Due to metabolic disorders, toxic metabolic products accumulate in the blood. The basis of this phenomenon is the mixing of arterial and venous blood inside the heart. These are blue vices, in which the child has cyanosis of the skin, auricles, lips, as well as rapid breathing.

White defects are characterized by discharge of venous blood from left to right. With white defects in babies, blanching of the skin and cold extremities are observed. Having a defect in the form of a heart disease, the child quickly gets tired during feeding, sucks badly at the breast. The pediatrician may hear heart murmurs and note slow weight gain. However, heart murmurs may not always mean the presence of a disease. Therefore, if a heart disease is suspected in newborns, a consultation with a cardiologist is necessary.

To date, it is not possible to determine the cause of congenital heart defects in children. This vital important organ It is laid and formed from the 2nd to the 8th week of pregnancy, that is, during the period when a woman often does not yet know about motherhood. Therefore, it is very important at this time to avoid the influence of harmful factors that can lead to the development of defects. The most important among them are the following:

maternal bad habits (smoking, drug use)
the influence of certain drugs (antibiotics, hormonal pills)
heredity
gene and chromosomal mutations
chronic diseases in women diabetes, endocrine diseases)
infectious diseases that a woman suffered during pregnancy (rubella, herpes, flu)
excessive exposure, radiation
harmful working conditions
woman's age (over 35)

Remember, the earlier heart defects in newborns are detected, the greater the hope for its timely and successful treatment.

Treatment of heart disease

Congenital heart defects in children are treatable in 90% of cases. Today, thanks to modern medicine, this disease is successfully cured. Like any other disease, heart disease is easier to treat if it is detected at an early stage. Therefore, as soon as you notice unusual changes in the behavior and condition of the baby, contact a specialist. An additional examination will be scheduled if the doctor confirms that the symptoms present may be signs of heart disease. Heart disease can be diagnosed from birth in the first 3 months of a child's life using the following methods:

1) electrocardiography - this ultrasound method helps to determine how the heart works, its structure, and also checks the function of the valves,

2) cardiac catheterization - this method allows you to determine any defects, their size, location and severity,

3) echocardiography is a very accurate diagnostic method that allows you to assess the structural features and contractility of the myocardium.

Congenital heart disease in children can be diagnosed even in utero. As a rule, this can be done starting from the 14th week of pregnancy, when the woman undergoes an ultrasound. At the slightest suspicion of a heart disease in the fetus, and also if a woman is at risk, she is sent to a specialized institution. If a congenital heart disease is found in the fetus, then the birth will take place under the supervision of specialists, in a specialized hospital, where the child will subsequently be operated on.

Children with mild heart disease need observation by a cardiologist and regular check-ups. Over time, their heart can grow on its own. With heart disease in a newborn, it is necessary to be in the fresh air more often, to protect it from infections and stress. Treatment of heart disease depends on the degree of its complexity. Severe defects require surgical intervention in the first days of the baby's life. Sometimes operations are carried out in several stages: initially, the child's condition is relieved, and then they are already prepared for the operation to completely eliminate the defects.

Heart disease surgery can be open or closed. During a closed operation, the heart is not affected, and the operation is performed on the large blood vessels around it. In open surgery, the cavity of the heart is opened. At the time of the operation, the heart and lungs are switched off from the circulation. And the blood is enriched with oxygen and pumped throughout the body with the help of a heart-lung machine. After surgery, children need high-calorie nutrition and intensive care.

If your child has a heart defect, do not panic - modern medical technologies allow you to treat all types of defects and give positive results.

Heart disease in children is a pathology that occurs during fetal development, that is, it is congenital, it consists in a violation of the structure of the valvular apparatus, the anatomical features of the heart muscle itself and its vessels. Acquired defects in childhood are almost never found.

Congenital heart diseases occur in approximately 8 newborns per 1000 and are the first cause of death before the first year of life. If the child lives up to a year, then the prognosis becomes more favorable: at the age of up to 15 years, the number of deaths as a result of a defect is only 5% of the total number of sick children. In any case, the numbers are such that it becomes clear why such a disease is considered a serious problem that requires urgent action.

Reasons for the development of defects in children

Most often, heart defects in children develop as a result of hereditary predisposition. But their development directly depends on some factors that can damage the baby in the first trimester of its intrauterine development, since the formation of the defect occurs at 2-8 weeks:

viral diseases of the mother (rubella);
use of certain medicines during pregnancy;
alcoholism and drug addiction of parents;
constant intoxication in hazardous production;
radioactive radiation.

A high risk factor for this pathology in children whose parents have endocrine diseases, the age of the mother over 35 years, severe toxicosis during gestation, the presence of stillborns in history, there are relatives who have children with heart defects. But it is not yet possible to identify reliably all the causes of defects. The health of the father also plays a significant role in the likelihood of a child developing heart disease.

What are the vices

Heart defects in newborns can be different. In total, there are about 100 different pathologies. The following can be distinguished by frequency:

Ventricular septal defect (about 20%).
Atrial septal defect.
Open aortic duct.
Coarctation of the aorta.
Aortic stenosis.
Stenosis of the pulmonary artery.
Transposition of the great great vessels.

Clinicians divide the defects into varieties in which the skin of the child becomes cyanotic (blue defects) and turns pale (white defects).

Diseases can have different manifestations, each defect has its own symptoms. According to statistics, about 30% of children with such a diagnosis worsen from the first days of their lives. Parents should definitely pay attention if it is found that the baby:

The skin color changes, the distal parts of the limbs (fingers and toes), the nasolabial triangle, and the face require special attention.
Noticeable swelling in the region of the heart.
There are noticeable swelling.
When crying or straining, pallor or cyanosis appears with the simultaneous occurrence of cold sweat.
Poor suckling, slow development and weight gain.
Paroxysmal or persistent shortness of breath.
Heart rhythm disturbances.

This is how heart defects can manifest themselves in newborns. It is also necessary to pay attention if an older child complains of shortness of breath during physical exertion, palpitations that are not associated with emotional or physical overload, the occurrence of pain in the heart.

All these signs may indicate the presence of pathology of the heart muscle and require immediate examination and treatment by a pediatrician and cardiologist.

Timely diagnosis

It should be noted that many defects, if they are not too pronounced, can occur without any symptoms. But with a routine examination and auscultation of the heart, the doctor may pay attention to some features that are characteristic of this condition. In the heart, murmurs of varying intensity may be heard, which require differentiation. It is necessary to distinguish between organic, indicating the development of pathology, and functional, which do not require treatment and pass on their own.

Additional research methods in the form of an ECG, chest x-ray, Holter monitoring, ultrasound of the heart can reliably determine the presence or absence of heart disease in a child.

Necessary treatment

Heart defects in children vary in severity. And depending on this, the doctor prescribes treatment.

More than 50% of children with such a pathology may die without the use of urgent surgical intervention. Therefore, the only way out can be only an operation, which cannot be abandoned in any case. In the absence of immediate indications for a surgical solution to the problem, the cardiologist prescribes certain drugs that must be taken, strictly following the recommendations for time and dosage.

For example, diuretics, cardiac glycosides (digoxin), antiarrhythmics, etc. It does not make sense to give any recommendations on taking drugs, as well as on all drug treatment, since these pathologies are very serious, therefore it is not recommended to self-medicate.

Nevertheless, treatment for any should be to provide a regimen with the maximum stay of the child in the fresh air and exercise within the minimum load on the heart. The feeding of such children should be somewhat reduced in volume, but increased in the frequency of meals (for infants by 2-3 times), preference should be given to mother's milk.

Children who have been diagnosed with such a diagnosis as congenital heart disease should be registered with a cardiologist and pediatrician. In the first year of life, it is obligatory to examine the baby at least once every 3 months, as well as to conduct additional examinations every six months, and if necessary, more often. The severe course of the disease requires a monthly examination, and a sharp deterioration in the condition is a direct indication of hospitalization.

Parents play a big role in the treatment of such a child. They should closely monitor changes and symptoms and report the slightest deterioration to the attending physician. The presence of signs of respiratory or heart failure in a child serves as a reason for releasing him from lessons and physical education in children's preschool institutions and school. The cardiologist determines such a need. In the absence of such symptoms, sick children are shown therapeutic exercises, which are carried out in the clinic.

Children with heart defects should not be exposed to the sun for long periods of time. summer time and on severe frost in winter, since they have a high weather sensitivity, such a pastime can greatly worsen their condition.

There is no diet for such children, but nutrition must be varied and fortified. It is useful to use dried apricots, prunes, raisins, baked potatoes.

Susceptibility to infectious diseases in babies with congenital malformations, it requires careful sanitation of any focus of chronic infection. If an acute viral or infectious pathology appears, then the intensity of treatment should be maximum to prevent the development of complications from the heart. Bed rest compared to other children is extended by 2-3 days.

Even in the presence of a compensated defect, the salt regime should be limited. It is also necessary to protect the patient from drinking excessive amounts of fluid (the maximum daily volume is not more than 1.5 liters).

The environment in which the baby grows should be joyful and positive.

Constant prohibitions and a strict attitude can aggravate the condition and cause depression. You should only limit your mobility a little, especially when playing with older children, and avoid overexcitation. Nevertheless, it is necessary to show excessive guardianship or pity as little as possible. Such a child should not feel worse in something than other children.

It is an abnormal condition of the heart, expressed in the form of deformations of the partitions between the ventricles, damage to the valves, the appearance of holes between the chambers. For these reasons, the process of providing all organs with oxygen can be disrupted in a person. Violated with defects and blood circulation in the body.

The presence of heart defects in a person is fraught with a large number of complications. In addition to poor oxygen supply to the organs, he gradually begins to manifest, which, if not properly treated, can cause disability and even death.

Medicine has established that heart valves are at greater risk of defects: aortic and mitral. If the valves work properly, then the blood circulation in the body occurs in a timely manner. But if at least one of the valves has any defect, then a condition may occur when the heart muscle itself increases in size, and clots may appear in the blood, leading to blood clots.

Blood clots can cause pulmonary embolism, life-threatening. The fact is that with defects in the heart valves can be very narrow. At the same time, they can close poorly or open poorly, depending on the type of defect. Because of this, blood, when pumped out of one valve, penetrates into the valve from which it was pumped out. This creates a load on the muscle, and it is forced to increase in size.

The enlarged heart muscle greatly loses its elasticity, which invariably leads to heart failure. In addition to failure, a person can develop a stroke and.

There are the following causes of heart defects:

the congenital nature of the anomaly of the heart valves;
the presence of high blood pressure in a person, which is a harbinger of the disease;
the presence in a person of diseases, which include lupus, bacterial-type endocarditis, rheumatoid arthritis, infections of the heart valves, syphilis, rheumatism, which can cause a defect as complications;
a person taking the anti-migraine medicine Metisergide, which can cause heart disease;
the presence of a person already experienced a heart attack, weakening the heart valves;
oncological diseases and radiation therapy, weakening the heart muscle;
old age, at which the heart muscle weakens.

Types of heart defects

All heart defects are divided into acquired and congenital.

Acquired vice affects people of any age. Among the causes of this anomaly, concomitant diseases are more often distinguished. Among them may be: cardiosclerosis, syphilis, rheumatism. In half of all cases recorded by medicine, the mitral heart valves are affected. In 21% of cases, the anomaly appears in the semilunar heart valve. Acquired defects can also develop in the form of:

stenosis, which develops due to improper fusion of the valve leaflets;
insufficiency, in which the valve leaflets are shortened due to the consequences of atherosclerosis;
prolapse, in which the valve leaflets are everted directly into the cavity of the heart.

They appear at the stage of fetal development. There may be several reasons for this:

external causes, expressed in the presence of diseases in the future mother, in her medication, in poor ecology;
internal causes, expressed in genetic factors, which can predetermine the appearance of heart disease in the unborn child.

Symptoms of congenital malformations in children

Congenital heart disease has symptoms expressed in:

in children under 1 year old - tearfulness, irritability and poor weight gain;
the presence of tachycardia in children;
weak pulse;
blue skin (especially on the lips, extremities);
chest deformity;
murmurs in the heart when listening to the heartbeat of a child;
frequent shortness of breath in a child even in the absence of load.

Symptoms and signs of acquired defects

With acquired heart defects in patients, problems with the aorta are more often recorded. Much depends on how a person eats and monitors his physical health. The most susceptible to anomalies are people aged (after 55 years). The consequence of the disease can be progressive heart failure, the accompanying phenomena of which are heart pain, fatigue and shortness of breath.

Acquired heart defects are divided into:

mitral stenosis;
tricuspid insufficiency;
aortic stenosis.

It is a typical type of acquired heart disease, but it can sometimes occur in newborns. main reason defect is the presence of rheumatic endocarditis in a person, which he suffered at one time. The anomaly covers the mitral heart valve, as a result of which it acquires a funnel-shaped shape.

This type of pathology is successfully treated with a surgical method, but it is important to detect and diagnose it in time. Symptoms of mitral stenosis are expressed in the form of:

in which the goat on the face becomes blue;
discharge of blood from the mouth during coughing;
heavy breathing ();
weak and barely palpable pulse;
chest pain in the region of the heart;
strong cough;
, in which the atria contract with different rhythm and coordination;
frequent heartbeats (as a result of arrhythmia);
pulmonary edema in some cases.

Aortic stenosis can often be a congenital anomaly in children, in which the child can often complain of pain attacks behind the sternum.

The essence of the pathology is that there is a fusion of the valves at the mouth of the aorta. The disease often develops as an acquired anomaly due to complications after endocarditis, atherosclerosis.

Symptoms of the disease are quite pronounced:

strong cardiac tremors when lying on the left side;
pale skin;
pathological difference between upper and lower pressure, in which the first is below normal;
weak pulse;
headaches;
dizziness with fainting.

Methods for diagnosing pathology

Diagnosis of heart defects, both congenital and acquired, is reduced to a number of studies. Among them, the following are effective:

echocardiography;
phonocardiography;
x-ray of the heart;
general analysis of urine and blood;
Magnetic resonance imaging;
heart electrocardiogram

After carrying out these procedures, the doctor makes a diagnosis and takes measures to treat the pathology.

Ways to treat pathology in children and adults

Usually, heart defects in children and adults are treated by two methods - conservative and surgical. The main goal of treatment is to prevent the manifestation of heart failure. To maintain immunity as part of conservative treatment, patients are prescribed anti-inflammatory drugs without hormones. Also used means that improve blood circulation in the vessels.

When patients recover, they are prescribed cardiotrophic medications. If the heart disease in children and adults is of a bacterial nature, then they are prescribed penicillin antibiotics. This usually occurs when resulting from the activity of streptococcal bacteria.

Surgical treatment is carried out in cases where:

there is an increase in pressure in one of the ventricles of the heart;
there is shortness of breath and heart failure after an active load;
individual sections of the heart muscle increase in size.

Most often, it is heart defects in children that require urgent treatment. Early surgery saves the child's life and avoids complications. In other cases, the operation is performed in emergency cases, when there is a high threat to the life of an adult.

With mitral stenosis, mitral commissurotomy is performed. In this operation, the surgeon separates the valve leaflets that have grown together. by the most effective way surgical treatment mitral stenosis is considered valve replacement.

Similar operations are performed in cases of stenosis. In some cases, cardiac surgeons perform operations to completely replace the valves with artificial ones.

Heart disease is a congenital or acquired anomaly of the structures of the cardiovascular system, which leads to the development of disorders of the systemic (throughout the body) blood flow. Most often, this pathology is congenital and is diagnosed in utero or immediately after the birth of a child, less often at an older age. The main signs are cyanosis or pallor of the skin, shortness of breath, swelling, lag in physical development. Timely treatment of heart disease in children in most cases allows not only to avoid disability and ensure a high quality of life, but also to save life.

Congenital heart disease is usually diagnosed in the first few days of a newborn's life. However, there are times when it goes unnoticed and comes to light only years later. Acquired defects are now relatively rare. This is due to the widespread use of antibacterial agents and effective treatment streptococcal infection.

Types of anomalies

Children are diagnosed with a wide range of different heart defects. It is very important to determine exactly what kind of anomaly the patient has, because the prognosis and the effectiveness of treatment in the future depend on it. There are the following main types.

Pale defects. These are defects of the interventricular or interatrial septum, which are characterized by an increase in blood flow in the lungs with the development of pulmonary pathology and global circulatory disorders.
Blue vices. They are characterized by reduced blood oxygen saturation, which leads to hypoxia, cyanosis of the skin.
Narrowing of the lumen of the main vessels. Pathology that creates an obstacle to the exit of blood from the ventricles.

Congenital

The following congenital anomalies are most often diagnosed.

Ventricular septal defect. It is the most common congenital heart defect in newborns. When the "window" is small, expectant therapy is often recommended, since almost half of the children with this pathology spontaneously close the defect during the first year of life. If there is a large hole, surgery is recommended.
Atrial septal defect. It is an opening in the wall between the right and left atria. This defect does not close on its own, therefore, an operation is required.
Atresia (absence) of the pulmonary artery. With such an anomaly, blood from the right ventricle cannot flow into the pulmonary vessels. Pathology leads to a lack of saturation of red blood cells with oxygen in the lungs. This type of defect within a few days leads to the death of the child, and therefore requires urgent surgical intervention.
Pulmonary valve stenosis. Associated with an anomaly of the valve leaflets at the outlet of the right ventricle. In this case, the valve does not open enough, which leads to an overload of the heart muscle. In the absence of surgery, the child may die within the first three to four weeks of life.
Tetralogy of Fallot. This is one of the most severe and complex heart defects. It is characterized by the presence of four different anomalies diagnosed simultaneously. This "window" between the ventricles, narrowing of the pulmonary artery, the wrong position of the aorta and hypertrophy of the muscles of the right ventricle. The development of an infant with such a heart disease is slow, there is a slow, unexpressed cyanosis.
Transposition of the vessels of the heart. A very serious and life-threatening defect, when the ventricles are “mixed up”, from which large vessels emerge. As a result, oxygen does not reach the tissues at all, which leads to death without medical intervention.

Acquired

Of the acquired defects, the most common are:

insufficiency of the bicuspid valve;
mitral stenosis;
aortic stenosis;
aortic valve defect.

The clinic of acquired defects is combined with symptoms of rheumatism. As in the case of congenital anomalies, the lack of timely treatment leads to an increase in blood pressure in the lungs or the development of heart failure.

Why develops

In the first months of its intrauterine existence, the child goes through a number of stages in the development of organs and systems. Violation of any of them leads to abnormal formation of anatomical structures. It is still not known exactly why such a failure in development occurs. In 80% of cases, it is not possible to establish the etiology (cause) of a congenital heart defect.

It is believed that the following factors can cause white and blue heart defects in newborns:

genetic defects;
viral infections;
metabolic diseases and diabetes in the mother;
the presence of bad habits in the mother (alcohol abuse);
taking medications.

Proven bad influence on the fetus of certain groups of drugs and some viruses. Pharmaceuticals that can provoke heart disease include a group of antiepileptic drugs that increase the risk of congenital anomalies by one and a half times. The role of rubella, herpes and cytomegalovirus viruses has also been proven. Infection is especially dangerous in the first trimester of pregnancy.

Acquired heart disease in a child usually develops after an acute rheumatic attack, septic complications, and less commonly, a chest injury.

What is the danger

Depending on the type of defect (pale or blue), various disturbances in blood flow occur, as a result of which either it is not saturated with oxygen or it does not enter the organs in sufficient quantities. The presence of an anomaly in the structure of the heart leads to the development of a number of compensation mechanisms, which subsequently cause gross changes in the tissues. Significant heart defects can lead to the most unfortunate consequences - the death of a child.

Symptoms of heart disease in children

In the case of a heart defect, it is very important to identify it in a timely manner, because the prognosis for the health and life of the child largely depends on this. The main signs of heart disease in children are as follows:

respiratory disorders (frequent, with increased inhalation);
cyanosis of the skin, lips, nail plates;
the appearance of shortness of breath or cyanosis of the face during feeding;
increased heart rate;
swelling in the legs, in the abdomen;
rapid fatigue of the child, shortness of breath;
developmental delay.

Symptoms of heart disease in children can have different severity and manifest themselves both immediately after birth and at different periods of life. In addition, minor defects sometimes do not manifest themselves as any outward signs or are characterized only by psychological characteristics (psychological maladaptation, emotional instability, increased anxiety).

The presence of any symptoms indicative of heart disease should force the parents to consult the child with a cardiologist and undergo an examination. It is not necessary, on the advice of friends, to use various folk remedies. They are ineffective and will not help cure heart disease. The sooner a cardiac pathology is detected and its treatment is started, the better the prognosis.

Diagnostics

Activities aimed at identifying a congenital defect consist of three stages.

prenatal diagnosis.
Initial examination by a neonatologist, then observation by a pediatrician.
Specialized cardiac examination.

Acquired heart defects are diagnosed on the basis of physical examination data, a history of rheumatism clinic, and ultrasound results.

Prenatal

Such diagnostics allows diagnosing many heart defects even before the birth of a child. Modern ultrasound machines detect cardiac pathology in utero starting from the 16th week of a child's development. However, the optimal period is 20-22 weeks.

Even the detection of very severe anomalies does not mean that we will talk about termination of pregnancy. Rather, the newborn will need special care and appropriate treatment.

Pediatrician examination

Often the reason for conducting a specialized diagnosis of heart disease is the detection of pathological heart murmurs in a child, heard by a pediatrician during the initial examination. A heart defect is indicated by a coarse scraping noise that does not change its character with a change in body position, splitting of heart sounds.

However, it should be remembered that in 33% of newborns, heart murmurs can be heard and then disappear (up to six months of age). This is not a pathology and is associated with an adaptive mechanism aimed at adapting the newborn to new conditions of existence outside the mother's body. If, after six months, the heart murmur persists, a heart defect should be suspected.

Echocardioscopy (ultrasound method) is sufficient to clarify the cause of a heart murmur. If a pathology is detected, further additional examination is carried out in specialized centers.

Cardiology

The volume of diagnosis of heart disease in children is determined primarily by the severity of clinical symptoms and the proposed diagnosis. The following methods are the most informative.

Echocardioscopy (ultrasound of the heart). This method provides very accurate information about the size of all four chambers of the heart, the state of the valvular apparatus, and the characteristics of heart contractions. During the examination, the speed of blood flow and its direction are also determined, areas of turbulence are identified. The procedure is completely painless, however, it is necessary to calm the child and ensure his immobility.
Electrocardiography (ECG). The method allows to detect arrhythmias, conduction disturbances, changes in the electrical axis of the heart. However, this examination is less informative than ultrasound.
Holter monitoring. It consists in conducting continuous electrocardiography during the day. Using this method, explosive rhythm disturbances are diagnosed.
Radiography of the heart and lungs. Helps to determine the size of the heart and its shape, pathological changes in the lungs.
Cardiac catheterization. This is an invasive method of examination, it is performed only in large specialized centers and is used for severe heart defects. During the procedure, a catheter is inserted through a peripheral vein and advanced towards the heart. The technique helps to study the difference in pressure and the concentration of oxygen in the blood in the chambers of the heart.
Computed and magnetic resonance imaging. Modern tomographs provide the ability to obtain very clear images of the structures of the beating heart. With the help of special computer add-ons, three-dimensional images are obtained, which is necessary before surgery.

How are defects received in the womb treated?

Treatment of congenital heart defects is most often surgical. According to clinical guidelines, the urgency of the operation, indications and contraindications are determined by the existing pathology, the condition of the child, and the severity of pulmonary hypertension.

Severe anomalies (pulmonary artery atresia, vascular transposition) require surgery in the first few days after birth for health reasons. In the presence of milder defects, sometimes they adhere to expectant tactics or postpone surgical treatment and carry it out after a year or more.

Currently, the following types of heart operations are performed:

radical - a complete restoration of the normal anatomy of the heart is carried out;
palliative - allow only for a while to improve the state of hemodynamics;
with separation of circulatory circles - without complete restoration of the anatomy of the heart, blood flows from the right and left ventricles are separated.

Also, technically, heart surgery can be closed and open. In the latter case, the circulation is turned off and the cavity of the heart is opened.

Small defects are operated on using intravascular surgical techniques, when a surgical incision is not even required. According to doctors, such interventions are well tolerated by children and do not require long-term rehabilitation. How to treat blue or pale heart disease in infants in this way will be prompted in a specialized cardiac surgery center.

Rehabilitation

After surgical treatment, it will take some time for the rehabilitation of the child, the duration of which depends on the complexity and method of intervention. At home, you should adhere to the following recommendations:

good nutrition and rest;
fluid restriction;
observance of half-bed mode;
taking prescribed drugs (cardiac glycosides, diuretics);
physical therapy, massage, electrophoresis.

Treatment of acquired valvular disease

The treatment approach depends on the severity clinical manifestations and presence of complications. With compensated defects, clinical examination, good nutrition, adherence to the regimen, and limitation of physical activity are recommended.

With a severe degree of defect, accompanied by heart failure, the addition of drugs (cardiac glycosides, cardioprotectors) is required. According to indications, an operation is performed.

Risks and prevention

To exclude cardiac pathology in the fetus, an ultrasound examination and a number of genetic tests are performed, the results of which can indirectly determine developmental defects.

There is no specific prevention of heart defects in young children. Mothers during gestation need to give up bad habits, apply medicines only if there is strong evidence. From a psychosomatic point of view, it is recommended to avoid stress and negative emotions. In relation to acquired defects, timely antibiotic therapy of streptococcal infection is indicated.

Thus, heart disease in a child is a rather complex pathology that requires careful attention from parents and medical personnel. Best Option is a prenatal diagnosis that allows for early dates gestation to detect developmental anomalies. In addition, any symptoms in a newborn or infant that indicate heart disease should be the basis for contacting a pediatric cardiologist and performing echocardioscopy. Modern medicine in many cases can effectively eliminate the pathology and ensure the full development of the child.